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流感的预防与控制。免疫实践咨询委员会(ACIP)2007年建议

Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2007.

作者信息

Fiore Anthony E, Shay David K, Haber Penina, Iskander John K, Uyeki Timothy M, Mootrey Gina, Bresee Joseph S, Cox Nancy J

机构信息

Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA 30333, USA.

出版信息

MMWR Recomm Rep. 2007 Jul 13;56(RR-6):1-54.

Abstract

This report updates the 2006 recommendations by CDC's Advisory Committee on Immunization Practices (ACIP) regarding the use of influenza vaccine and antiviral agents (CDC. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2006;55[No. RR-10]). The groups of persons for whom vaccination is recommended and the antiviral medications recommended for chemoprophylaxis or treatment (oseltamivir or zanamivir) have not changed. Estimated vaccination coverage remains <50% among certain groups for whom routine annual vaccination is recommended, including young children and adults with risk factors for influenza complications, health-care personnel (HCP), and pregnant women. Strategies to improve vaccination coverage, including use of reminder/recall systems and standing orders programs, should be implemented or expanded. The 2007 recommendations include new and updated information. Principal updates and changes include 1) reemphasizing the importance of administering 2 doses of vaccine to all children aged 6 months--8 years if they have not been vaccinated previously at any time with either live, attenuated influenza vaccine (doses separated by > or =6 weeks) or trivalent inactivated influenza vaccine (doses separated by > or =4 weeks), with single annual doses in subsequent years; 2) recommending that children aged 6 months--8 years who received only 1 dose in their first year of vaccination receive 2 doses the following year, with single annual doses in subsequent years; 3) highlighting a previous recommendation that all persons, including school-aged children, who want to reduce the risk of becoming ill with influenza or of transmitting influenza to others should be vaccinated; 4) emphasizing that immunization providers should offer influenza vaccine and schedule immunization clinics throughout the influenza season; 5) recommending that health-care facilities consider the level of vaccination coverage among HCP to be one measure of a patient safety quality program and implement policies to encourage HCP vaccination (e.g., obtaining signed statements from HCP who decline influenza vaccination); and 6) using the 2007--2008 trivalent vaccine virus strains A/Solomon Islands/3/2006 (H1N1)-like (new for this season), A/Wisconsin/67/2005 (H3N2)-like, and B/Malaysia/2506/2004-like antigens. This report and other information are available at CDC's influenza website (http://www.cdc.gov/flu). Updates or supplements to these recommendations (e.g., expanded age or risk group indications for currently licensed vaccines) might be required. Immunization providers should be alert to announcements of recommendation updates and should check the CDC influenza website periodically for additional information.

摘要

本报告更新了美国疾病控制与预防中心(CDC)免疫实践咨询委员会(ACIP)2006年关于流感疫苗和抗病毒药物使用的建议(CDC. 流感的预防与控制:免疫实践咨询委员会[ACIP]的建议。《发病率与死亡率周报》2006;55[第RR - 10号])。建议接种疫苗的人群以及推荐用于化学预防或治疗的抗病毒药物(奥司他韦或扎那米韦)并未改变。在某些建议每年常规接种疫苗的人群中,估计接种率仍低于50%,这些人群包括年幼儿童、有流感并发症危险因素的成年人、医护人员(HCP)以及孕妇。应实施或扩大提高接种率的策略,包括使用提醒/召回系统和预立医嘱项目。2007年的建议包含了新的和更新的信息。主要的更新与变化包括:1)再次强调,对于所有6个月至8岁、以前未曾接种过任何一种减毒活流感疫苗(两剂间隔≥6周)或三价灭活流感疫苗(两剂间隔≥4周)的儿童,需接种两剂疫苗,后续年份每年接种一剂;2)建议在第一年接种仅一剂的6个月至8岁儿童次年接种两剂,后续年份每年接种一剂;3)突出此前的一项建议,即所有希望降低患流感风险或向他人传播流感风险的人,包括学龄儿童,均应接种疫苗;4)强调免疫接种提供者应在整个流感季节提供流感疫苗并安排免疫接种门诊;5)建议医疗机构将医护人员的接种率视为患者安全质量项目的一项衡量指标,并实施鼓励医护人员接种疫苗的政策(例如,让拒绝接种流感疫苗的医护人员签署声明);6)采用2007 - 2008年三价疫苗病毒株,即A/所罗门群岛/3/2006(H1N1)类似株(本季节新增)、A/威斯康星/67/2005(H3N2)类似株以及B/马来西亚/2506/2004类似株抗原。本报告及其他信息可在CDC流感网站(http://www.cdc.gov/flu)获取。可能需要对这些建议进行更新或补充(例如,扩大当前已获许可疫苗的适用年龄或风险组指征)。免疫接种提供者应留意建议更新的公告,并应定期查看CDC流感网站以获取更多信息。

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